Doctor Explains Lindsay Lohan’s Early Rehab Release

| August 26, 2010 - 2:05 pm

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In light of Lindsay Lohan’searly release from rehab, Celebuzz called on Dr. John Sharp, a faculty member at the David Geffen School of Medicine at UCLA, to explain why doctors may have decided to turn Lindsay loose early. He also gives his expert medical opinion on what she should and should notdo next in order to stay on the right path.

Dr. Sharp is nationally renowned psychiatrist specializing in integrated psychotherapy and psycho-pharmalogic treatment of disorders like depression, addiction, and attention deficit. Among his other prestigious doctor gigs – like being a faculty member at Harvard Medical School – Sharp is the executive medical director for Bridges to Recovery, a residential rehab of sorts for people with mood disorders who would rather not stay in a hospital for treatment.

And just to clarify, he’s not treating Lindsay, but he is in direct knowledge of her case. As Dr. Sharp tells Celebuzz: “I’ve treated celebrities, and from what I can tell, other situations that seem similar to this.”

CELEBUZZ: What do you think about her early dismissal from inpatient rehab?

SHARP: That’s on the one hand concerning because we know that, basically, the longer somebody is in intensive treatment, the more likely they are to do well. On the other hand, that’s primarily based on the treatment of drug and alcohol addicts. People who are really in that kind of trouble usually do better when they have more inpatient intensive treatment. There is a question as to what exactly is the basis of her treatment now. Good doctors always base treatment on diagnosis, so presumably, because she’s been under the care of good doctors at UCLA, they were able to really get to the bottom of what was driving her behavioral troubles, and we don’t know what that is. There was a rumor that perhaps she was misdiagnosed with ADD. Perhaps she didn’t need to be taking Adderall. If that were true, and if she were tapered off for Adderall, which can be done pretty quickly and usually pretty smoothly, then perhaps what’s underneath isn’t looking so bad. It’s a question: What do you find when you layer that off. Someone could have, for example, bi-polar disorder underneath. Some one, for example, could have depression, but if she didn’t seem to have too much trouble when her Adderall was taken away, they may have been able to put together a good, comprehensive treatment plan that actually would be fine for her to advance to as an outpatient. Hopefully, this is a positive indication that she doesn’t need to be in longer inpatient stay.

What are some of the things associated with being misdiagnosed with Adderall? Can Adderall consumption make a person drink more alcohol than they would, or promote them to do other drugs?

If you or I were given Adderall and we didn’t need it, yeah, we’d feel kind of wound up. We’d not feel like sleeping. When we came off it, we’d feel moody and feel like crashing, and to regulate our emotional state, we might – if we normally liked to have a drink or two – we might decide to have two or three times our normal amount. It can really drive you to problems in terms of intoxication and behavior. We were seeing some behaviors like that with her. That’s why it’s tempting to believe that was a big driver of her problems, and maybe without that she was actually doing a whole lot better. Maybe that’s why she doesn’t need to be in long-term inpatient treatment. The problem with her being discharged earlier as opposed to later is that it puts more responsibility on her. See, that’s the thing. When someone’s discharged, then they have to shoulder more of the responsibility for their ongoing treatment success … She’s got to get up in the morning. She’s got to go the meetings that are required that day. It looks like the judge is taking this seriously, and by reports, has really mandated that she follow the sequence of treatments that the doctors proposed, and that certainly could help. We’re all encouraged by the law to walk the line and to do the right thing.

How normal is it for a person to be prescribed Dilaudid for dental surgery? What are the complications involved in the prescription of this drug?

Most of us who’ve gotten dental procedures certainly have not gotten Dilaudid. That’s really near the top of the totem pole as far as opiates are concerned. Maybe she had an elaborate dental procedure. Maybe she was in elaborate pain, but most of the time you get a much weaker opiate. It certainly wouldn’t be a safe medication for an addict to take. If she doesn’t have a problem with an addiction to opiates and she has dental surgery again, she probably could have that, but I would be very concerned if I were the treater.

What should she do now to stay on the right path?

There’s an old joke that goes like this: How many shrinks does it take to change a lightbulb? Just one, but the bulb has to really want to change, so there’s truth in that. If Ms. Lohan is in a receptive state where she can really square up to the reality as it’s been, in other words, that she has been in trouble… She’s certainly been in trouble with the law. She’s been in trouble behaviorally. If going to jail and then going out to treatment has allowed her to accept that there really is a need for her to take better care for herself in the way that the doctors at UCLA have outlined, then I think it is possible this could be a turnaround for her. We’ve seen time and time again people make an entire turnaround in their life as a result. The problem is it’s not always so easy. She’s had a number of intensive treatment opportunities before, and she’s gotten into trouble after she’s been out on her own, but I think this time it looks like it is different, and she’s not really out on her own.

Besides taking more drugs and other obvious things like DUI, what else should she not do right now?

She shouldn’t have too much unstructured time. I think she should be involved in her life in a production way, both with regard to treatment and also with respect to her work. At the same time – and this would be true for anyone – she shouldn’t get so exclusively involved with stressful work that temptations arise in terms of how to manage the stress of what she’s being asked to do. She shouldn’t get overly involved with a super demanding schedule that would leave her not enough time to take care of herself, and she shouldn’t get too close with any kind of bad temptation. If there someone saying, “Lindsay, you don’t need to listen to what those UCLA doctors are saying. Here’s some more Adderall. That was the stuff that worked for you…” I’m sure there’s not going to be somebody like that standing right next to her, but if there were, she’d have to walk away and not listen. She has to position herself in her life so that she can be strong.

Will Lindsay stay clear of the law from now on? Will she stay clean? Tell us in the comments section.